34D0242372 CLIA NUMBER - WILSON IMMEDIATE CARE PA

Laboratory Demographics

  • CLIA Code: 34D0242372
  • Facility Name: WILSON IMMEDIATE CARE PA
  • Facility Address: 1725 S TARBORO ST
    WILSON, NC
    ZIP 27893
  • Facility Phone: 252 237-2891
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHANSON DEVAUL
  • NPI Number: 1679521983
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 34D0242372
LAB Type Physician Office
Facility Name WILSON IMMEDIATE CARE PA
Street 1725 S TARBORO ST
City WILSON
State NC
ZIP 27893
Phone 252 237-2891
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/1/2025
Certificate Expiration Date 12/31/2026
Facility Type Physician Office
Lab Director CHANSON DEVAUL

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This page was last updated on: 9/29/2025